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Krainc D, Martin WJ, Casey B, Jensen FE, Tishkoff S, Potter WZ, Hyman SE. Shifting the trajectory of therapeutic development for neurological and psychiatric disorders. Sci Transl Med 2023; 15:eadg4775. [PMID: 38190501 DOI: 10.1126/scitranslmed.adg4775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 10/13/2023] [Indexed: 01/10/2024]
Abstract
Clinical trials for central nervous system disorders often enroll patients with unrecognized heterogeneous diseases, leading to costly trials that have high failure rates. Here, we discuss the potential of emerging technologies and datasets to elucidate disease mechanisms and identify biomarkers to improve patient stratification and monitoring of disease progression in clinical trials for neuropsychiatric disorders. Greater efforts must be centered on rigorously standardizing data collection and sharing of methods, datasets, and analytical tools across sectors. To address health care disparities in clinical trials, diversity of genetic ancestries and environmental exposures of research participants and associated biological samples must be prioritized.
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Affiliation(s)
- Dimitri Krainc
- Davee Department of Neurology, Simpson Querrey Center for Neurogenetics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Bradford Casey
- Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Frances E Jensen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Tishkoff
- Departments of Genetics and Biology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Steven E Hyman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
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Safar K, Pang EW, Vandewouw MM, de Villa K, Arnold PD, Iaboni A, Ayub M, Kelley E, Lerch JP, Anagnostou E, Taylor MJ. Atypical oscillatory dynamics during emotional face processing in paediatric obsessive-compulsive disorder with MEG. Neuroimage Clin 2023; 38:103408. [PMID: 37087819 PMCID: PMC10149418 DOI: 10.1016/j.nicl.2023.103408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/21/2023] [Accepted: 04/14/2023] [Indexed: 04/25/2023]
Abstract
Children and youth with obsessive-compulsive disorder (OCD) demonstrate difficulties with social, emotional and cognitive functions in addition to the core diagnosis of obsessions and compulsions. This is the first magnetoencephalography (MEG) study to examine whole-brain neurophysiological functional connectivity of emotional face processing networks in paediatric OCD. Seventy-two participants (OCD: n = 36; age 8-17 yrs; typically developing controls: n = 36, age 8-17 yrs) completed an implicit emotional face processing task in the MEG. Functional connectivity networks in canonical frequency bands were compared between groups, and within OCD and control groups between emotions (angry vs. happy). Between groups, participants with OCD showed increased functional connectivity in the gamma band to angry faces, suggesting atypical perception of angry faces in OCD. Within groups, the OCD group showed greater engagement of the beta band, suggesting the over-use of top-down processing when perceiving happy versus angry emotions, while controls engaged in bottom-up gamma processing, also greater to happy faces. Over-activation of top-down processing has been linked to difficulties modifying one's cognitive set. Findings establish altered patterns of neurophysiological connectivity in children with OCD, and are striking in their oscillatory specificity. Our results contribute to a greater understanding of the neurobiology of the disorder, and are foundational for the possibility of alternative targets for intervention.
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Affiliation(s)
- Kristina Safar
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada.
| | - Elizabeth W Pang
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Marlee M Vandewouw
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Kathrina de Villa
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Alana Iaboni
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Muhammed Ayub
- Department of Psychology, Queen's University, Kingston, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Jason P Lerch
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Department of Medical Imaging, University of Toronto, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
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